Omicron exposes inflexibility of Europe’s public hospitals

Omicron exposes inflexibility of Europe’s public hospitals
Medical staff members care for a COVID-19 patient in the intensive care unit at the Strasbourg University Hospital, eastern France, Thursday Jan. 13, 2022. (AP)
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Updated 16 January 2022

Omicron exposes inflexibility of Europe’s public hospitals

Omicron exposes inflexibility of Europe’s public hospitals
  • That includes doctors, nurses and technicians at public hospitals

STRASBOURG, France: A World Health Organization official warned last week of a “closing window of opportunity” for European countries to prevent their health care systems from being overwhelmed as the omicron variant produces near-vertical growth in coronavirus infections.
In France, Britain and Spain, nations with comparatively strong national health programs, that window may already be closed.
The director of an intensive care unit at a hospital in Strasbourg is turning patients away. A surgeon at a London hospital describes a critical delay in a man’s cancer diagnosis. Spain is seeing its determination to prevent a system collapse tested as omicron keeps medical personnel off work.
“There are a lot of patients we can’t admit, and it’s the non-COVID patients who are the collateral victims of all this,” said Dr. Julie Helms, who runs the ICU at Strasbourg University Hospital in far eastern France.
Two years into the pandemic, with the exceptionally contagious omicron impacting public services of various kinds, the variant’s effect on medical facilities has many reevaluating the resilience of public health systems that are considered essential to providing equal care.
The problem, experts say, is that few health systems built up enough flexibility to handle a crisis like the coronavirus before it emerged, while repeated infection spikes have kept the rest too preoccupied to implement changes during the long emergency.
Hospital admissions per capita right now are as high in France, Italy and Spain as they were last spring, when the three countries had lockdowns or other restrictive measures in place. England’s hospitalization rate of people with COVID-19 for the week ending Jan. 9 was slightly higher than it was in early February 2021, before most residents were vaccinated.
This time, there are no lockdowns. The Institute for Health Metrics and Evaluation, a population health research organization based at the University of Washington, predicts that more than half of the people in WHO Europe’s 53-country region will be infected with omicron within two months.
That includes doctors, nurses and technicians at public hospitals.
About 15 percent of the Strasbourg hospital system’s staff of 13,000 was out this week. In some hospitals, the employee absentee rate is 20 percent. Schedules are made and reset to plug gaps; patients whose needs aren’t critical must wait.
The French public hospital’s 26 ICU beds are almost all occupied by unvaccinated patients, people ”who refuse care, who refuse the medicine or who demand medicines that have no effectiveness,” Helms said.
She denied 12 requests for admission Tuesday, and 10 on Wednesday night.
“When you have three patients for a single bed, we try to take the one who has the best odds of benefiting from it,” Helms said.
In Britain, like France, omicron is causing cracks in the health system even though the variant appears to cause milder illness than its predecessors. The British government this month assigned military personnel, including medics, to fill in at London hospitals, adding to the ranks of service members already helping administer vaccines and operate ambulances.
At the Royal Free Hospital in London, Dr. Leye Ajayi described a patient who faced delays in his initial cancer diagnosis.
“Unfortunately, when we eventually got round to seeing the patient, his cancer had already spread,” Ajayi told Sky News. “So we’re now dealing with a young patient in his mid-50s who, perhaps if we’d seen him a year ago, could have offered curative surgery. We’re now dealing with palliative care.”
Nearly 13,000 patients in England were forced to wait on stretchers more than 12 hours before a hospital bed opened, according to figures released last week from the National Health Service.
Britain has a backlog of around 5.9 million people awaiting cancer screenings, scheduled surgeries and other planned care. Some experts estimate that figure could double in the next three years.
“We need to focus on why performance has continued to fall and struggle for years and build the solutions to drive improvement in both the short and long term,” said Dr. Tim Cooksley, president of the Society for Acute Medicine.
Having the capacity to accommodate a surge is crucial, and it’s just this surge capacity that many in Europe were surprised to learn their countries lacked. The people in a position to turn that around were the same ones dealing with the crisis daily.
In the midst of the first wave, in April 2020, WHO’s Europe office put out a how-to guide for health systems to build slack into their systems for new outbreaks, including identifying a temporary health workforce.
“Despite the fact that countries thought they were prepared for a pandemic that might come along, they were not. So it’s building the ship as it sails,” said Dr. David Heymann, who previously led the World Health Organization’s infectious diseases department.
But France had been cutting back hospital beds — and doctors and nurses — for years before the pandemic. Building it back up in a matter of months proved too much when the current wave infected hospital staff by the hundreds each day. Even allowing symptomatic COVID-19-positive health workers to report for work hasn’t been enough.
Britain’s NHS Confederation, a membership organization for sponsors and providers, says the public health service went into the pandemic with a shortage of 100,000 health workers that has only worsened.
The first wave of the pandemic pushed Spain’s health system to its limit. Hospitals improvised ways to treat more patients by setting up ICUs in operating rooms, gymnasiums and libraries. The public witnessed, appalled, retirees dying in nursing homes without ever being taken to state hospitals that were already well over capacity.
After that, the Spanish government vowed not to let such a collapse happen again. Working with regional health departments, it designed what officials call “elasticity plans” to deal with sudden variations in service demands, especially in ICUs.
The idea is that hospitals have the equipment and, in theory, the personnel, to increase capacity depending on the need. But critics of government health policy say they’ve warned for years of inadequate hospital staffing, a key driver of the difficulty delivering care in the current wave.
“The key thing is flexibility, having flexible buildings that can expand, having staff that are flexible in terms of accepting task shifting, having flexibility in terms of sharing loads more of a regional structure,” said Dr. Martin McKee, a public health professor at the London School of Hygiene and Tropical Medicine.
Ultimately, though, McLee said: “A bed is an item of furniture. What counts is the staff around it,” McKee said.
Helms, the Strasbourg intensive care doctor, knows that all too well. Her unit has space for 30 beds. But it has only enough staff to care for the patients in the 26 beds currently occupied, a situation unlikely to change quickly after omicron burns through the region.
In the same hospital’s infectious diseases unit, frantic schedulers are borrowing staff from elsewhere in the facility, even if it means non-COVID-19 patients get less care.
“We’re still in the middle of a complex epidemic that is changing every day. It’s hard to imagine what we need to build for the future for other epidemics, but we’re going to have to reflect on the system of how we organize care,” said Dr. Nicolas Lefebvre, who runs the infectious diseases unit at the Strasbourg hospital.
He said Europe is prepared to handle isolated outbreaks as it has in the past, but the pandemic has exposed weakened foundations across entire health systems, even those considered among the world’s best.
Frédéric Valletoux, the head of the French Hospital Federation, said policymakers at the national level are acutely aware of the problem now. For 2022, the federation has requested more resources from nursing staff on up.
“The difficulty in our system is to shake things up, especially when we’re in the heart of the crisis,” Valletoux said.


Tokyo COVID-19 curbs declared illegal in ‘Kill Bill’ restaurant case

Tokyo COVID-19 curbs declared illegal in ‘Kill Bill’ restaurant case
Updated 57 min 46 sec ago

Tokyo COVID-19 curbs declared illegal in ‘Kill Bill’ restaurant case

Tokyo COVID-19 curbs declared illegal in ‘Kill Bill’ restaurant case
  • The orders, enacted in the capital during various states of emergency, included shortened operating hours and a ban on alcohol sales

TOKYO: Japan’s “Kill Bill” restaurant operator prevailed in a court case on Monday that declared Tokyo’s now defunct COVID-19 infection curbs were illegal.
The orders, enacted in the capital during various states of emergency, included shortened operating hours and a ban on alcohol sales, though there was a compensating government subsidy. Businesses that didn’t comply were subject to fines.
Global-Dining Inc, which runs more than 40 restaurants, defied the restrictions, taking the city government to court over the matter.
The district court said the Tokyo government had not provided a “rational explanation” for the measures. The court determined they had been illegal but it denied Global-Dining’s claim for $0.80 (¥104) in damages.
The restrictions ended in March. Whether this ruling would inhibit the city government in acting against any renewed COVID-19 outbreak is unclear.
In a statement, Global-Dining president Kozo Hasegawa, said the case revealed the “injustice and sloppiness of the Tokyo Metropolitan Government.” His company crowd-funded more than 25 million yen to fight the case.
Global-Dining’s Gonpachi restaurant, with a cavernous inner courtyard, inspired the fight scene in Quentin Tarantino’s first “Kill Bill” film. It was the site of a dinner between then Prime Minister Junichiro Koizumi and then US President George W. Bush in 2002.


Indonesia tourist bus smashes into billboard, killing 14

Indonesia tourist bus smashes into billboard, killing 14
Updated 16 May 2022

Indonesia tourist bus smashes into billboard, killing 14

Indonesia tourist bus smashes into billboard, killing 14
  • The bus was returning from a trip to Central Java’s Dieng Plateau, a popular mountain resort

SURABAYA, Indonesia: A tourist bus with an apparently drowsy driver slammed into a billboard Monday on a highway on Indonesia’s main island of Java, killing at least 14 people and injuring 19 others, police said.
The bus, carrying Indonesian tourists from Surabaya, the capital of East Java province, was returning from a trip to Central Java’s Dieng Plateau, a popular mountain resort, when it hit the billboard on the Mojokerto toll road just after dawn, East Java traffic police chief Latief Usman said.
Television news showed police and medical personnel removing victims from the bus, which crashed just 400 meters before the highway exit.
Usman said police are still investigating the cause of the accident, but that the driver reportedly appeared drowsy before the crash.
He said police haven’t yet questioned the driver, who suffered severe injuries. Nineteen people were being treated in four hospitals in Mojokerto, mostly for broken bones.
Road accidents are common in Indonesia because of poor safety standards and infrastructure.


Ukraine says troops defending Kharkiv have reached Russian border

Ukraine says troops defending Kharkiv have reached Russian border
Ukraine says troops defending Kharkiv have reached Russian border. (Reuters)
Updated 16 May 2022

Ukraine says troops defending Kharkiv have reached Russian border

Ukraine says troops defending Kharkiv have reached Russian border
  • Ukraine said troops defending Kharkiv had repelled Russian forces and advanced as far as the border with Russia

KYIV: Ukraine said on Monday troops defending the country’s second-largest city, Kharkiv, had repelled Russian forces and advanced as far as the border with Russia.
Reuters could not immediately verify Ukraine’s battlefield account and it was not clear how many troops had reached the Russian border and where.
If confirmed, it would suggest a Ukrainian counter-offensive is having increasing success in pushing back Russian forces in the northeast after Western military agencies said Moscow’s offensive in the Donbas region had stalled.
Ukraine’s defense ministry said in a Facebook post that the 227th Battalion of the 127th Brigade of Ukraine’s armed forces had reached the border with Russia, adding: “Together to victory!”
Kharkiv region governor Oleh Sinegubov wrote on the Telegram messaging app that troops of the 227th Battalion had restored a sign on the state border.
“We thank everyone who, risking their lives, liberates Ukraine from Russian invaders,” Sinegubov said.
Ukraine has scored a series of successes since Russia invaded on Feb. 24, forcing Russia’s commanders to abandon an advance on the capital Kyiv before making rapid gains around Kharkiv.
Moscow calls its invasion of Ukraine a “special military operation” to rid the country of fascists, an assertion Kyiv and its Western allies say is a baseless pretext for an unprovoked war.


French city rekindles burkini row with pool rule change

French city rekindles burkini row with pool rule change
Updated 16 May 2022

French city rekindles burkini row with pool rule change

French city rekindles burkini row with pool rule change
  • Burkini seen as a symbol of creeping Islamism by its critics and an affront to France’s secular traditions

GRENOBLE, France: The Alpine city of Grenoble is set to reignite one of France’s recurring summer debates on Monday when it votes to authorize the “burkini” in state-run swimming pools.
The all-in-one swimsuit, used by some Muslim women to cover their bodies and hair while bathing, has become almost as topical as ice cream and sun hats during the holiday season in recent years.
Seen as a symbol of creeping Islamism by its critics and an affront to France’s secular traditions, many right-wingers and some feminists would like to ban it outright.
It is prohibited in most state-run pools — for hygiene, not religious reasons — where strict swimwear rules apply to all, including men who are required to squeeze into tight-fitting trunks.
Grenoble’s city council, dominated by the EELV green party, is set to scrap its bathing dress code on Monday, effectively authorizing long body coverings, beach shorts and topless bathing.
“Our intention is to remove all of the abnormal clothing restrictions,” mayor Eric Piolle said recently. “The issue is not being for or against the burkini specifically.”
Opponents see it differently, including the influential conservative head of the wider Auvergne-Rhone-Alpes region, Laurent Wauquiez, who has promised to withdraw funding from the city.
“I am convinced that what Mr.Piolle is defending is a dreadful dead end for our country,” Wauquiez said at the beginning of May, accusing him of “doing deals with political Islam” to “buy votes.”
The regional spat has put the burkini back in the headlines nationally, animating French talk shows and the political class ahead of parliamentary elections next month.
The issue of how people dress for the pool touches on highly sensitive topics in France, including fears about the influence of Islam and threats to the country’s cherished secularism.
The right to worship freely is constitutionally protected, but the French state is also bound by law to be neutral in religious matters, including inside institutions.
“The burkini aims, purely and simply, to impose Islamist values at the heart of bathing areas and public leisure pursuits,” an open letter written by opposition councillors in Grenoble said last week.
Attempts by several local mayors in the south of France to ban the burkini on Mediterranean beaches in the summer of 2016 kicked off the first firestorm around the bathing suit.
The rules, introduced after a string of terror attacks in France, were eventually struck down as discriminatory.
Three years later, a group of women in Grenoble caused a splash by forcing their way into a pool with burkinis, leading the prime minister at the time to insist that the rules should be followed.
French sports brand Decathlon also found itself at the center of a similar row in 2019 when it announced plans to sell a “sports hijab” enabling Muslim women to cover their hair while running.
Monday’s vote in Grenoble “is an important moment for everyone concerned and their allies, but also in the fight against Islamophobia and control over women’s bodies,” local campaign group Citizens’ Alliance wrote on its Facebook page.
Demonstrations supporting and opposing the move are also planned in the city following the council meeting where mayor Piolle is expected to succeed in pushing through the change.
French feminists are split, with some seeing the burkini as a symbol of male oppression and others such as Caroline De Haas writing that “no one should be stigmatized in a pool because of their choice of swimwear.”
Grenoble would not be the first to change its rules, however.
The northwestern city of Rennes quietly updated its pool code in 2019 to allow burkinis and other types of swimwear.
The debate about the burkini comes as French Muslim women footballers are battling to overturn a ban on the wearing of religious symbols during competitive matches.
The French Football Federation currently prevents players from playing while wearing “ostentatious” religious symbols such as the Muslim hijab or the Jewish kippa.
A women’s collective known as “les Hijabeuses” launched a legal challenge to the rules in November last year.


Kim Jong Un orders North Korean military to stabilize supply of COVID-19 drugs

Kim Jong Un orders North Korean military to stabilize supply of COVID-19 drugs
Updated 16 May 2022

Kim Jong Un orders North Korean military to stabilize supply of COVID-19 drugs

Kim Jong Un orders North Korean military to stabilize supply of COVID-19 drugs
  • Last week brought Pyongyang’s first acknowledgment of an ‘explosive’ outbreak
  • Kim: Drugs procured by the state were not reaching people in a timely and accurate way

SEOUL: Leader Kim Jong Un has ordered North Korea’s military to stabilize distribution of COVID-19 medicines in the capital, Pyongyang, in the battle on the country’s first confirmed outbreak of the disease, state media said.
Last week brought the North’s first acknowledgment of an “explosive” outbreak, with experts warning it could wreak devastation in a country with limited medical supplies and no vaccine program.
Drugs procured by the state were not reaching people in a timely and accurate way, Kim told an emergency politburo meeting on Sunday, before visiting pharmacies near the capital’s Taedong River, state news agency KCNA said.
Kim ordered immediate deployment of the “powerful forces” of the army’s medical corps to “stabilize the supply of medicines in Pyongyang City,” it added.
Although authorities had ordered distribution of national reserves of medicine, pharmacies were not well-equipped to perform their functions smoothly, Kim added, the agency said.
Among their shortcomings were a lack of adequate drug storage other than showcases, while salespeople were not equipped with the proper sanitary clothing and hygiene in their surroundings fell short of standards, the leader said.
He criticized the “irresponsible” work attitude, organization and execution by the cabinet and the public health sector, it added.
Neighbouring South Korea will spare no effort to help the North fight its outbreak, President Yoon Suk-yeol told parliament on Monday, saying it was ready to provide COVID-19 vaccines and other medical support if Pyongyang agrees.
South Korea’s unification ministry has offered to hold working-level talks with North Korea on offering support for its neighbor, which is battling its first confirmed outbreak of COVID-19, the ministry said on Monday.
The ministry, charged with maintaining relations between the two nations, said it had expressed willingness to provide medicines, from vaccines to test kits, as well as technical co-operation, based on the South’s experience with quarantine.

North Korea’s tally of the fever-stricken stood at 1,213,550, with 50 deaths by Sunday, after KCNA reported 392,920 more cases of fever, and eight more deaths. It did not say how many suspected infections had tested positive for COVID-19.
The North has blamed a large number of the deaths on people who were “careless in taking drugs” because of a lack of knowledge about the omicron variant of coronavirus and its correct treatment.